Site Search Navigation

Site Navigation

Site Mobile Navigation

Exploring the Links Between Depression and Weight Gain

By Roni Caryn Rabin June 16, 2010 1:13 pmJune 16, 2010 1:13 pm

Obesity and depression often go hand in hand. But does being obese make people depressed, or can depression cause weight gain?

In a society enamored with thinness, many assume that being fat is depressing — that if there is a cause and effect relationship, it’s obesity that makes people feel down. But “there is an alternative explanation,” said Belinda L. Needham, an assistant professor of sociology at the University of Alabama at Birmingham, “and that is that being depressed actually makes you gain weight.”

Her new study found that young people who reported symptoms of depression like feeling sad or hopeless gained weight more rapidly over a 15-year period and accrued more belly fat than those who appeared to be happier. In the study, which was published in The American Journal of Public Health, those who were obese initially may have been depressed but did not become more depressed over time.

“When you’re depressed, you tend to be inactive and not to exercise as much, and you tend to eat more,” Dr. Needham said. “And if you experience high levels of depression and take antidepressants, those drugs are associated with weight gain as well.”

She noted that there could be some third underlying factor that is actually causing both the depression and the obesity. “The way we think about it in the study is that chronic stress is the mediator – that chronic stress arousal leads to depressed affect, which then leads to excess weight gain,” she said. The stress hormone cortisol, for example, stimulates and promotes fat storage, especially in the abdominal area, since the body has evolved to store calories during times of stress.

The relationship between obesity and depression has always been a murky one. Some obesity experts, like Yale University’s Kelly Brownell, say that the “causal arrow goes both ways,” but that the stigma surrounding obesity leads to discrimination and unrelenting bias that inevitably results in depression.

Dr. Needham noted that public health efforts to rein in obesity that don’t take emotional well-being into account and treat underlying depression may fall short. “Obesity and depression are both really serious public health issues that everyone is concerned about, but we don’t really understand a lot about the relationship between the two,” she said.

“We tend to separate the mind and the body in our culture, but they’re much more connected than we realize,” she said. “We’re not going to understand how to treat obesity if all we focus on is diet and exercise.”

Her study analyzed data from 5,115 men and women ages 18 to 30 who participated in the Coronary Artery Risk Develop in Young Adults, or Cardia, study. Participants took a survey to assess symptoms of depression every five years, and their body mass index and waist circumference were tracked over time.

The researchers found that while everyone gained weight over a 15-year period, those who had a high body mass index did not become more depressed over time. Those who reported more symptoms of depression, however, put on more abdominal fat over time: they started with a waist circumference that was about 1.6 centimeters, or about six-tenths of an inch, greater than those with few depressive symptoms; by year 20, their overall waist measurements were 2.6 centimeters, or over an inch, bigger than the group that was not depressed.

Earlier studies have come to mixed conclusions. A study of teenagers in middle school and high school found, as in Dr. Needham’s study, that being depressed predicted obesity a year later, but that being overweight was not associated with a subsequent increase in depression. A study of older adults, however, found the opposite: that obesity at the start of the study was associated with an increased risk for depression five years later, but that initial depression was not linked to a greater risk for obesity later.

Those discrepancies between young and old may have something to do with age and developmental differences, said Bruce Blaine, a health psychologist at St. John Fisher College in Rochester, who reviewed 16 studies on the link between depression and weight gain and found depressed people were at significantly higher risk for becoming obese. Most dramatically affected were teenage girls, who were two-and-a-half times more likely to become obese if they were depressed.

“Depressed people are not that different physiologically from stressed people,” Dr. Blaine said. “Their sympathetic nervous system is chronically turned on, and one of the consequences of this is increased fat storage.

“We tend to think of depression as an outcome — that something else causes us to become depressed,” Dr. Blaine said. “We don’t think of depression as a cause of other health outcomes.”

It seems that when people say they are depressed, what they actually mean is that they are unhappy. Why do doctors prescribe an antidepressant, which alters a persons chemistry, for people who are not depressed, but rather, are unhappy? These aren’t happy pills! Those people need medicine to help them handle their stress, and support to overcome the problems in their lives that are making them unhappy. They don’t need medicine that will change their body chemistry to make them numb and fat. Gaining weight just adds another reason to feel unhappy. Properly managed anti-anxiety medicine is a great help, but the government’s anti-drug war does everything it can to keep doctors from properly prescribing it out of fear that some people will become addicted.

Finally, researchers are focusing on the real crux of the obesity epidemic. Modern life with its particular patterns of work and family interactions produces unhappiness. Food, like any other stimulant, “treats” that unhappiness. Americans are larger on average across the spectrum, meaning even the relatively skinny ones are bigger than their counterparts 30 years ago. We’re in a collective funk that can only be mitigated by changes in the way we, as a culture, redefine what it means to be alive.

In 1999, I was misdiagnosed with simple depression (I was actually bipolar) by a well-meaning family doctor who prescribed Paxil over the phone. I was healthy and athletic when I started, but within six months, I had gained 50 pounds and lost all libido. This state of affairs continued for ten years, even after a correct diagnosis in 2002 and a cessation of Paxil. I’m now struggling to lose the weight back. Antidepressants often have severe side effects beyond weight gain, including increasing the risk of suicide, and they should be used with great caution.

@gattrell: “…when people say they are depressed, what they actually mean is that they are unhappy…”

I’m no doctor, but I do have depression. I tried for many years to deny that I had it, or that I needed drugs to help me with it. It’s not quite a state of being “unhappy,” but something more profound than that. I have found that a small dose of an antidepressant (not a “happy pill”–I’m not “happy” all the time) has made a big difference in my daily life. And yes, I’ve gained weight, something else I’ll need to deal with. But at least I can get out of bed in the morning and get to work.

gattrell; please allow me to make the distinction between situational sadness and clinical depression. I have had one clinical depression and it was as if the light bulb went out in my head. Not at all like when I dealt with turbulences of life in healthier ways.
Clinical depression is biological. the brain chemistry is really affected. I needed anti-depressants so that I could sleep, regain my attention span; have enough energy for a walk, become sociable like I had always been. My functioning was very impaired for several wks but I brightened up quickly from the SSI. Therapy helped of course, but I needed the med to get me out of bed to drive to therapy. Yes, I gained some wt. But I don’t know how I would have survived that bottomless pit of depression had I not had anti-depressants. Anti-anxiety medicine was going to make me sleepy and even less energetic.

Article says, “young people who reported symptoms of depression like feeling sad or hopeless gained weight more rapidly over a 15-year period and accrued more belly fat than those who appeared to be happier.”

CORRELATION DOES NOT EQUAL CAUSATION.

The most that can accurately be said – as a result of this ‘study’ – is that depression and weight gain come together.

There is a lot to be depressed about in this country. People are worried about their jobs, paying off debt, health care, paying for their children’s college education, their retirement, their aged parents, you name it. Our society isn’t structured to support people or towards healthy habits. People are working more for less or not working. Days are only 24 hours but we seem to be living in a 32 hours per day mode. Very few interactions are easily accomplished. For example, one can get lost in phone menu hell and never get the answer one needs. It can be funny but it can be frustrating as well.

We’ve made it easier to use drugs to solve problems. Is a child too active, too unfocused, or too difficult in school? Drug him. Don’t make sure that every child gets enough time to run around and play. Cut recess, cut gym, and expect children to sit still for longer than they can. Do the same to adults at work. Watch as they become inefficient, lethargic, depressed, or hyperactive, inefficient and depressed.

Depression can result when we realize how little control we have over our lives or how easily everything we’ve worked for can disappear.

There is a big difference between depression and unhappiness, as anyone who has suffered from severe depression knows. Being depressed does, however, tend to make one very unhappy.

As for these studies––hmmm… I went through a bout of pretty severe depression this past year and went from 115 to 100 lbs. Some people may eat more when depressed, some people find it very difficult to eat. Maybe someone should do an expensive study to find out that––whoa––not everyone reacts to things in the same way!

“When you’re depressed, you tend to be inactive and not to exercise as much, and you tend to eat more”

Yep. Weight gain with depression party of one here. People who haven’t been depressed just don’t understand how hard it seems just to do simple tasks when you’re depressed. All you really want to do is stay in bed or watch TV on the couch all day. Grabbing snack-type food from the kitchen is way easier than cooking, plus gives nearly effortless relief from some pain and boredom, so you eat a lot of high calorie food too.

Much over-eating is because we have a lack of any other kind of pleasure. My dad cannot be left alone. He’s sick, cranky, and has dementia so noboby comes around except a home health aide for 15 minutes a week. Noise irritates him so I hide like a teenager in my bedroom to listen to forbidden music. I can’t remember the last time I had fun. I was almost buff when I first started taking care of him, but now I eat because that’s the only thing pleasurable I can do in his house. I exercise but my dad keeps the house hot, and, exercising in a tiny hot room all alone doesn’t bring a lot of joy into my life. I’m probably not the only one eating because she is tired, lonely, and overwhelmed. I’m not the person I used to be!

Regarding weight gain that is not part of one’s normal lifestyle, has anyone considered the factor of “pleasure” — or perhaps more accurately, “pleasure substitute”?
Sex is usually one of one’s better pleasure providers. When one has a healthy sex life, that person can be deprived of many other qualities of life, but a high degree of self-confidence and life enjoyment remains. Pleasure is the main element of what is supplied, and counted upon.
When for medical reasons, the sexual experience is diminished or stopped altogether, my theory is that sooner or later. that person seeks pleasure from other sources.
One of those directions is the total experience of eating. Hunger is not necessarily the stimulant. The sensory experience of consuming orally can become incredibly pleasurable, involving taste, mouth and lips pleasure, the security of a constant supply, as well as the feeling of
being satiated or fulfilled.
As an example, this writer had his prostate removed over 10 years
ago. As a single person, the pleasure from sex dropped immediately, as did the opportunities for meaningful relationships. As time went on,
I noticed I was eating more and liking it more, and I went from a normal
weight, for about 6-feet in height, of 180 lbs. to my current weight of
240 lbs. From this experience, I believe I was psychologically substituting the pleasure of eating for the pleasure of sex.
For the first year afer the operation, I did experience a degree of
depression. But other activities in my life did grow to the point that I
was not aware of missing sex as much as I had at first, and on top of that, my life in all other areas seemed to be quite successful and satisfying. But I did miss the pleasure factor, and humans know how important pleasure is to one’s overall well-being.
So there’s my theory. What do you think?

I can honestly say after struggling with depression (diagnosed with chronic severe depression) all my life and trying all kinds of things to make me feel better (exercise, moderating stress levels, etc.) I have finally given in to the anti-depressant drugs. It has definitely made a difference in my mood, but I have noticed a HUGE increase in my weight. I used to run marathons and do long-distance cycling, now that has all gone away and I am on the verge of having high blood pressure due to my weight gain. I do go to the doctor on a regular basis, including my therapist, psychologist, and family physician. My doctors are all weighing the benefits with the consequences. I guess high blood pressure is better than trying to turn into oncoming buses.

It is not true that all antidepressants make a person gain weight. Effexor is one antidepression that gives you the jitters, cuts your appetite and increases your heart rate – and the end result is that you LOSE weight. And there are some doctors who give a certain antidepressant to fat people precisely because it is a stimulant and appetite suppressor, not because they are depressed per se.

I have bipolar disorder. I’ve been on a mix of lithium, luvox, remeron, and now seroquel, for the past 17 years (along with a wide variety of other drugs which didn’t work as well. I will attest that depression (which still occurs even with all these drugs) leads to weight gain. There are several reasons: one, feeling depressed leads one to seek out foods that might stimulate a happier emotional feeling and a better sense of being alive: large quantities of potato chips, premium ice cream, tiramisu, etc. At least your tongue is feeling something other than despair. Secondly, when depressed, it is almost impossible to muster any concern at all that these actions will lead to weight gain or unhappiness. If you are feeling like you’d be happy to cease to exist, and you are the lowest person on earth, how can you care at all about whether this might gain you 3 or 5 pounds? You can’t. So when you’re not depressed, you are vigilant about exercise and calorie counting, and when you are depressed, it all comes back, and unfortunately, you are always hovering around a body mass index of 29. Depressing in itself.

Just to clarify, not everyone who is depressed is merely unhappy. However many are. When I was getting divorced my doctor prescribed antidepressants. I wasn’t depressed. I had no symptoms of depression. I was totally stressed out. Antidepressants aren’t for stress and anxiety. They are for chemical depression. Chemical depression doesn’t have a cause in daily life. It might be triggered by something that happens in someone’s life but it takes on a life of its own. Most people who say they are depressed actually hate their job, or want a divorce, or don’t have enough money…The only reason antidepressants are used for stress is that the government has taken the stance that doctors who prescribe anti-anxiety medications are abetting addicts.

I took Paxil for about 5 years and gained weight even when my depression seemed to be in remission. I went from a somewhat chubby 180 lbs to an obese 210. Since quitting Paxil about two years ago I’ve lost almost 50 lbs. I manage my depression by exercising a lot, at least an hour almost every day. Neither medication nor fitness are a cure but I’m certainly happier today in my fitter non-medicated state.

Nothing exactly news-bombish about depressed people eating a bit more and moving a little less. Those can be common symptoms. However not much discussed here about the emotionally soothing reward the body gets from food –kind of nature’s anti-depressant for many.
But the hulking availability of salt/sugar/fat-infused comfort foods puts us all in the US at risk… Put a tray of Krsipy Kreme’s in front of a break-up victim and… well, watch your fingers.
Surely part of the connection lies with the pleasure center nudged by stuff like dopamine, the party animal and Oprah neuro-transmitter in one for humans.
Before you can convince a depressed person to hold off on the soothing face-stuffing, it helps to have an alternative energy-good feeling source. Exercise is one, socializing is another and anti-depressants are actively hawked to the saddening crowd.
Are any of those really more immediately appealing than a chocolate muffin? Bio Com-pu-tah sez, “No!”
ALSO: What’s with a blanket statement like “antidepressants are associated with weight gain”? With dozens, maybe hundreds of different kinds of anti-depressants, to simply lump them into a phrase like that does a disservice and is wrong.”
SOME antidepressants are linked with weight gain, SOME ARE NOT. Some are linked with weight loss. Some of them are linked with the placebo effect.
The truth is that “depression” is a massive umbrella that can cover everything from grieving over grandma to catatonia to being morose for months because you got caught cheating.
It is a diagnosis useful for insurance forms, but each case of depression and obesity presents itself with its own personal peculiarities: YOUR expression of genetics, environment and behavior.
Anti-depressant food? A slice of lemon meringue might be just the thing for your sad girlfriend, but it would be deadly for a depressed diabetic. All depends.
If you are lucky you will find your way a wise doc, a gym, maybe some good meds and a fridge stocked with healthy food. Oh yeah, and maybe somebody to love.

News? Well the real news is that the researcher can’t figure out that the connection is that food is a stimulant to the bodies pleasure centres and thus if one is depressed the, then food provides a pleasure not gained int he environment. Many people become over weight because they make up for other pleasures not gained elsewhere in their lives with food. Hence a depressed person, ie one who is not being satisfied by other activities, eats–how simple is that?

Whenever I’ve had periods of feeling depressed, I’ve lost my appetite and lost weight. I’ve always reasoned that when someone is unhappy they tend to be self-destructive, and as a naturally very thin person it is weight loss that is self-destructive to me.

For me, this connection makes sense. I gained 25 pounds while depressed my junior/senior years of high school– moving me from the middle of my BMI range up to the top– and I’d lost it all my the summer after my freshman year of college, where I was far happier and more fulfilled. Depression didn’t make me obese, but I was DEFINITELY eating my feelings for a while there, since food was one of the only enjoyable things I had going for me.

But I think that it’s a pretty individual thing. This was true for me, but I also know people who lose weight when depressed or who are overweight and perfectly happy.